Abstract Details

Title Development of De novo Functional Seizures after Epilepsy Surgery

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S35 - Epilepsy/Clinical Neurophysiology (EEG): Clinical Epilepsy (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background

Functional seizures (FS) (also known as psychogenic non-epileptic seizures (PNES) or dissociative seizures) are seizures that mimic an epileptic seizure but have no associated epileptogenic EEG changes and are thought to have a psychological basis. Epilepsy surgery can be an effective means of treatment for patients with drug refractory seizures, but it is important to understand the complications that can arise from surgery.

Objective

The purpose of this evaluation was to identify the frequency and risk factors of de novo FS in patient after epilepsy surgery.

Design/Methods The surgical data based showed 1116 patients who underwent epilepsy surgery from 1998 to 2022. The clinic notes were reviewed and identified 37 patients who developed de novo FS post-surgery. They were characterised by their age, sex, age of surgery, duration of epilepsy before surgery, pre-operative psychiatric co- morbidities, type/site of surgery, and post-operative complications

Results

37 patients were identified (30F, 7M). The mean age at the time of surgery was 36.2 (17-52 years). 31 patients had documented post-operative de novo FS. 16 patients had a documented pre-operative psychiatric diagnosis. 10 patients developed immediate post-operative complications and de novo FS an average of 9.8 months after surgery. 4 patients with no past psychiatric issues developed psychosis following immediate post-operative complications. Patient with no immediate post-operative complications with or without pre-operative psychiatric diagnosis developed de novo FS on average of 29.4 months after epilepsy surgery

Conclusions : 1) The rate of development of de novo FS after epilepsy surgery is low (2.77%). 2) The patients who have de novo FS after surgery have high rates of pre-operative psychiatric diagnoses (43.2 %), are predominantly female (81.1%) , and have immediate post-op complications (27%). 3) Immediate post-operative complications can result in new functional seizures developing less a year after surgery

Authors/Disclosures
Merlin M. Manoj, MBBS PRESENTER	Dr. Manoj has nothing to disclose.
Mahinda Yogarajah, MD	Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for MEWA. Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Forensic Access. Dr. Yogarajah has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Eopinex. The institution of Dr. Yogarajah has received research support from MRC. Dr. Yogarajah has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
John S. Duncan, MD (National Hospital for Nervous)	No disclosure on file